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In a city notorious for high teen pregnancy and infant mortality rates, a legislative push could strip local family-planning organizations of Title X funding, forcing those federal funds on the Shelby County Health Department.

The amendment, passed by the Tennessee Senate General Welfare Committee on April 27th, changes the language regarding family-planning funding to reflect that federal funds may only be given to county health departments.

Although the legislation has yet to be approved by the Senate Finance Committee, Barry Chase, executive director of Planned Parenthood Greater Memphis, said the odds aren't good.

"It is proceeding as an amendment of the budget," Chase said. "Since the budget is going to have to be passed, there's no reason to believe all of this won't take place."

By stripping Planned Parenthood of federal funding, Tennessee legislators are pushing county health departments to take on 5,000 or so Title X patients formerly served by nonprofits. That's something the Shelby County Health Department is not prepared for.

In a letter sent on March 24th, the Tennessee Department of Health directs the Shelby County Health Department to "take every step possible to be able to accept all family-planning funds provided by the state."

The county's health department director Yvonne Madlock responded: "Shelby County does not have the ability to take on the additional substantial financial cost of operating a larger program. However, if the state were able to make additional funds to support the full cost of providing comprehensive family-planning services to the 10,000-plus patient case load ... Shelby County Government would consider accepting a contract for the larger funding level."

In other words, cutting Title X funding for Planned Parenthood and other family-planning services could actually cost the state more, as the county health department would need time and money to develop the infrastructure, staff, and systems to take on twice as many patients. The onus could fall on taxpayers to make up the difference, and an already strained TennCare could see an increase in enrollment.

Chase said the amendment is a case of ideology trumping fiscal responsibility: "Economics is the most important thing. Budget is the most important thing, until we get unto a matter of culture, and then economics takes a backseat."

If economics are taking a backseat, underprivileged women are riding on the back bumper. Planned Parenthood of Greater Memphis serves 5,000 Title X patients a year, 95 percent of whom are impoverished, 77 percent of whom are under the age of 29, and 71 percent of whom are non-white.

"This is not a blow to Planned Parenthood. This is a blow to the women we serve," Chase said. "We need to be talking about what's going to happen to poor women, who have no insurance, who want to plan their pregnancies, who need health screenings, and won't be able to get those services if we don't get these funds."

Although the $747,900 Planned Parenthood receives in Title X funding makes up 25 percent of its annual budget, the funding runs out by the end of April each year. As a result, Planned Parenthood contributes $350,000 of its own funding to pick up the slack and is not reimbursed by the state.

Said Chase: "I don't think the county health department has the money to do that."